Pay-for-performance test run yields mixed results: report
By
James M. Berklan
Sep 01, 2012
An Affordable Care Act provision testing pay-for-performance incentives faces an uncertain future after a federal demonstration program testing it has so far brought “disconcerting” results.
Measure would put an end to rule that bans CNA training
By
James M. Berklan
Mar 07, 2019
Providers and their lobbyists hailed moves in mid-February that they hope will bring an end to aide-training lockouts.
Surveyor testing mulled
By
James M. Berklan
Nov 01, 2020
Mandated COVID-19 testing for nursing home surveyors and ombudsmen was “under active consideration” by federal health officials, a top figure told providers in early October.
Family wins camera case
By
James M. Berklan
Jul 06, 2017
The Minnesota Department of Health ruled against a provider recently in a closely watched case involving a surveillance camera in a resident room.
Ask the payment expert: I am seeing an increase in Medicare Replacement Policy additional document requests....
By
Caryn Adams
Oct 01, 2020
I am seeing an increase in Medicare Replacement Policy additional document requests. How should we respond?
Ask the payment expert … about inaccurate MDS therapy information
By
Patricia Boyer
Feb 01, 2013
What happens if my therapy company makes an error on the MDS and as a result, a change of therapy was missed? Are we still responsible?
Ask the payment expert … about RACs
Apr 06, 2015
I thought the Recovery Audit Contractors were on hold, so why did I receive a request from our RAC for a Medicare Advantage resident?
CMS warns providers not to skip resident interviews
By
James M. Berklan
Feb 01, 2012
Skilled nursing operators, apparently overwhelmed or defiant, have not been completing resident interviews as mandated by the new MDS 3.0 resident assessment tool, a top official with the Centers for Medicare...
Ask the payment expert about …one star
By
Patricia Boyer
Oct 25, 2018
On top of PBJ affecting the star ratings, CMS also is performing on-site and remote audits to verify data submitted. Even if you have a vendor submit your data, it cannot be stressed enough: You are ultimately...
Ask the Payment Expert about … expedited review
By
Patricia Boyer
Sep 04, 2015
The expedited review process was developed so a resident could quickly appeal the process if he or she disagreed when a facility decided that a resident is no longer covered under skilled services.